<form id="submitForm">
<div class="weui-cells__title">收货人姓名</div>
<div class="weui-cells">
    <div class="weui-cell">
        <div class="weui-cell__bd">
            <input class="weui-input" name="name" id="name" type="text" value="#(receiver.name??'')" placeholder="请收货人姓名...">
        </div>
    </div>
</div>
<div class="weui-cells__title">收货人手机</div>
<div class="weui-cells">
    <div class="weui-cell">
        <div class="weui-cell__bd">
            <input class="weui-input" name="mobile"  value="#(receiver.mobile??'')" id="mobile" type="text" placeholder="请输入收货人手机...">
        </div>
    </div>
</div>
<div class="weui-cells__title">收货人地区</div>
<div class="weui-cells">
    <div class="weui-cell">
        <div class="weui-cell__bd">
            #if(receiver??)
            <input class="weui-input" value="#(receiver.province??'') #(receiver.city??'') #(receiver.area??'')" id="cityPicker" type="text" placeholder="请输入收货人所在城市...">
            #else
            <input class="weui-input" value="" id="cityPicker" type="text" placeholder="请输入收货人所在城市...">
            #end
        </div>
    </div>
</div>
<div class="weui-cells__title">收货人详细地址</div>
<div class="weui-cells weui-cells_form">
    <div class="weui-cell">
        <div class="weui-cell__bd">
            <textarea class="weui-textarea" name="address" placeholder="创业大厦11栋1101室" rows="3">#(receiver.address??'')</textarea>
        </div>
    </div>
</div>
<div class="button-padding">
    <input type="hidden" value="#(receiver.id??'')" name="id">

    <input type="hidden" id ="province" value="#(receiver.province??'北京')" name="province">
    <input type="hidden" id ="city" value="#(receiver.city??'北京市')" name="city">
    <input type="hidden" id ="area" value="#(receiver.area??'东城区')" name="area">

    <input type="hidden" id ="province_code" value="#(receiver.province_code??'')" name="province_code">
    <input type="hidden" id ="city_code" value="#(receiver.city_code??'')" name="city_code">
    <input type="hidden" id ="area_code" value="#(receiver.area_code??'')" name="area_code">

    <a href="javascript:;" id="submitBtn" class="weui-btn weui-btn_primary">保存信息</a>
</div>
</form>